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New System Devised To Guide Doctors Treating Patients With Symptomatic Myocardial Bridging
Date:7/1/2008

Nitrates should be avoided. In rare cases, beta- blockers might be considered temporarily to relieve symptoms.

Type B: Initiate beta-blockers or calcium channel blockers. If symptoms are not relieved, quantitative coronary angioplasty or invasive blood-flow studies should be performed, after which stenting may be considered if there is objective evidence of reduced blood flow to the heart muscle.

Type C: Initiate beta-blockers or calcium channel blockers. If symptoms are refractory, consider stenting of the bridged segment.

"One of our most important recommendations is that Type C patients - those with hemodynamic changes - always be treated, regardless of results of non-invasive stress testing," Schwarz said, adding that the authors believe the new classification system will enable cardiologists worldwide to better risk -stratify
and treat patients with this frequent congenital coronary anomaly.

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